Development of a VA Clinician Resource to Facilitate Care Among Veterans Experiencing Homelessness

Background: Emergency departments (EDs) often identify and manage the medical, mental health, and social needs of veterans experiencing homelessness.ED clinicians may facilitate postdischarge engagement for these individuals because many of them do not receive outpatient care from the US Department of Veterans Affairs (VA).This multiphase pilot project sought to identify ED clinicians' experiences in caring for veterans experiencing homelessness, including perceived gaps in knowledge and resources.Observations: Eleven VA clinicians who worked in the ED in 2022 and 2023 participated in qualitative interviews for this project.Interviews were analyzed using directed content analysis and coded according to a framework matrix modeled on the interview guide.A thorough review of interview findings and engagement with 10 subject matter experts led to the development of a clinician resource to facilitate post-ED service engagement.ED clinicians expressed confidence in the care provided to patients experiencing homelessness in the VA ED, but also described compassion fatigue.Knowledge gaps regarding available VA and community social services for veterans experiencing homelessness were common, especially among clinicians with limited training in those areas.Nearly all clinicians interviewed requested a centralized resource to facilitate the process of connecting veterans to postdischarge social services.This resource emphasized improved service delivery, enhanced clinician empathy when treating veterans experiencing homelessness, and increased knowledge of social services available within VA and the community.Conclusions: The resource developed in this study may increase clinicians' awareness of VA and community services to address the health and social needs of veterans experiencing homelessness.